title: Counseling of female veterans about risks of medication-induced birth defects.
abstract: BACKGROUND
  Medications that may increase risk of birth defects if used during pregnancy or immediately preconception are dispensed to approximately half of female Veterans who fill prescriptions at a VA pharmacy.
  
  
  OBJECTIVE
  To assess receipt of counseling about risk of medication-induced birth defects among female Veterans of reproductive age and to examine Veterans' confidence that their healthcare provider would counsel them about teratogenic risks.
  
  
  METHODS
  Cross-sectional analysis of data provided by 286 female Veterans of Operation Iraqi Freedom and/or Operation Enduring Freedom who completed a mailed survey between July 2008 and October 2010.
  
  
  METHODS
  We examined associations between demographic, reproductive, and health service utilization variables and female Veterans' receipt of counseling and confidence that they would receive such counseling.
  
  
  RESULTS
  The response rate was 11 %; the large majority (89 %) of responding female Veterans reported use of a prescription medication in the last 12 months. Most (90 %) of the 286 female Veterans who reported medication use were confident that they would be told by their healthcare provider if a medication might cause a birth defect. However, only 24 % of women who received prescription medications reported they had been warned of teratogenic risks. Female Veterans who used medications that are known to be teratogenic were not more likely than women using other medications to report having been warned about risks of medication-induced birth defects, and fewer were confident that their health care providers would provide teratogenic risk counseling when needed.
  
  
  CONCLUSIONS
  Female Veterans may not receive appropriate counseling when medications that can cause birth defects are prescribed.
authors.affiliation: Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. schwarzeb@upmc.edu
authors.forename: Eleanor Bimla
authors.initials: EB
authors.lastname: Schwarz
authors.forename: Kristin
authors.initials: K
authors.lastname: Mattocks
authors.forename: Cynthia
authors.initials: C
authors.lastname: Brandt
authors.forename: Sonya
authors.initials: S
authors.lastname: Borrero
authors.forename: Laurie C
authors.initials: LC
authors.lastname: Zephyrin
authors.forename: Harini
authors.initials: H
authors.lastname: Bathulapalli
authors.forename: Sally
authors.initials: S
authors.lastname: Haskell
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000517:prevention & control*; D000328:Adult; D055826:Afghan Campaign 2001-; D003376:Counseling / Q000379:methods* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008137:Longitudinal Studies; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods* / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors; D014728:Veterans